Clozapine is an atypical antipsychotic formulation indicated for schizophrenic patients who are unresponsive or intolerant to traditional antipsychotic therapy. Treatment with this agent is prevalent among schizophrenic patients under psychiatric hospital care, but not among non-hospitalized patients. The aim of this study was to evaluate the response to clozapine treatment, and specifically the effects on the overall functioning of a group of out-patient treatment-resistant schizophrenics. Data from 66 treatment-resistant schizophrenics in Cyprus, 28 female and 38 male, were retrospectively retrieved. The scales used for assessment were Global Assessment of Functioning Scale (GAF) and the Positive and Negative Syndrome Scale (PANSS). Also, white blood cell (WBC) counts were examined. Based on the GAF scale it was determined that there was a 49.7±23.6 SD point (P<0.001) significant improvement in the functioning of these patients at the end of the evaluation period with clozapine. Furthermore, utilizing the PANSS, it was concluded that treatment with clozapine significantly improved the positive and negative symptoms as well as the general psychopathology of this patient group. In total, 9 patients were taken off the medication because 2 patients (3%) were completely cured, 5 patients (8%) were unresponsive, 2 (3%) were non-compliant, 1 (2%) developed diabetes and 1 (2%) had considerably low WBC counts during the treatment. The incidence of WBC reduction and need for discontinuation of therapy falls within the expected range of this abnormality in patients taking clozapine. WBC counts were performed weekly for the first 18 weeks and monthly thereafter showed that there was no negative effect on the WBC counts of 65 out of the 66 patients, and thus indicate that clozapine can be safely administered at an out-patient basis. The data indicate a strong improvement in the functioning of this group of patients under outpatient clozapine treatment, without compromising patient safety.

Key words: Schizophrenia, antipsychotic treatment, out patients clozapine, functioning, GAF (Global Assesment Functioning), Scale, PANSS (Positive and Negative Symptoms) Scale.

Y. Mikellidis (page 361) - Full article